Med-Info | Special Issue | Volume 13 | Number 2
Past Issues

Dr. Susan Love Speaks about "Breast Cancer: Myths and Realities"

You are cordially invited to join us at a luncheon featuring renowned author and breast cancer physician Dr. Susan Love. The event will be held on May 13, 1998 at the Washington State Convention Center. Tickets are $25. At the event, Dr. Love will be available for book signing. Her two books, "Dr. Susan Love's Breast Book" and "Dr. Susan Love's Hormone Book" can be purchased at the event, thanks to the University Village Barnes and Noble store. To register for this event, call 206-368-1739.

Facts about Breast Cancer
  • Every woman is at risk for breast cancer. Over a woman's lifetime (to age 95 or older), she has a one in eight chance of developing breast cancer, and a one in 28 risk of dying from breast cancer. Breast cancer among men is relatively rare, with 1,400 cases diagnosed in the U.S. annually.
  • Ten-year probability estimates may be a better way to determine risk. For example, a 60 year old woman has a 1 in 29 probability of developing breast cancer over the next ten years. A 50 year old woman has a 1 in 41 probability of developing the disease in the next ten years.
  • The five year survival rate following early diagnosis and treatment is 96%. There are more than 1.6 million breast cancer survivors in America today.
  • In 1997, the American Cancer Society began recommending that women in their forties have a mammogram every year. Because breast cancer found in younger women is often more aggressive, the Northwest Hospital Seattle Breast Center has recommended for many years that every woman over 40 should have an annual mammogram.

Symptoms of Breast Cancer
  • A lump or thickening in the breast, with or without pain.
  • Skin dimpling or puckering on either breast.
  • Any changes in the shape, texture or color of the skin.
  • A nipple that has become inverted, or looks pushed in.
  • Discharge from one or both nipples.
  • Localized breast pain, not related to the hormonal cycle.
If you notice any of these symptoms, contact your physician immediately.

Message from KOMO ABC 4 TV

Watch KOMO ABC 4 during the months of April and May for special reports and public service announcements on breast cancer detection and treatment. In addition, persons may visit the KOMO ABC 4 website at www.komotv.com to link with other sponsor websites.

KOMO ABC 4 is pleased to be part of Northwest Hospital's efforts to heighten awareness of the need for early detection and treatment of breast cancer during the month of April and beyond.

Seattle Breast Center Leads the Community in Stereotactic Breast Biopsies

Core biopsies offer women an accurate, minimally invasive and cost effective alternative to surgical excisional biopsy. These techniques need only local anesthesia and are performed on an outpatient basis.

A new addition to the stereotactic biopsy procedure is the technologically advanced Mammotome Breast Biopsys System, which allow the exam to be performed more quickly.

Dr. Marita Acheson,Seattle Breast Center, commented, "This procedure allows most patients with benign lesions to avoid surgery. In those women in whom cancer is found, it enables the patient to be an active participant in surgical planning."

Seattle Breast Center Leads the Community in Stereotactic Breast Biopsies

Core biopsies offer women an accurate, minimally invasive and cost effective alternative to surgical excisional biopsy. These techniques need only local anesthesia and are performed on an outpatient basis.

A new addition to the stereotactic biopsy procedure is the technologically advanced Mammotome Breast Biopsys System, which allow the exam to be performed more quickly.

Dr. Marita Acheson,Seattle Breast Center, commented, "This procedure allows most patients with benign lesions to avoid surgery. In those women in whom cancer is found, it enables the patient to be an active participant in surgical planning."

Community Education Classes and Support Groups

Breast Cancer Support Group, a group for women during their diagnosis, treatment and recovery phases of breast cancer. For more information, call 206-368-1606.

Women and Heart Disease: Heart disease is a major health issue for women. Learn about risk factors, prevention, diagnosis, and treatment of heart disease, as well as new research about the disease. May 19. Free. Call 206-368-1621 to register.

Grandparents Class: So much has changed! Come and learn firsthand, from a nurse and grandmother of eleven, about current childbirth and newborn care practices. And, with humor and sensitivity discuss your concerns, role within the family and the grandparent/grandchild relationship. May 11, 7-9pm. Cost: $20. Call 368-1621 to register.

For more information about our educational classes, call 206-368-1621. To learn more about our support groups, call 206-368-1606.


Message to Breast Cancer Patients from Nordstrom

We at Nordstrom are deeply committed to the special needs of women dealing with breast cancer or breast surgery.

We invite you to consider us as a caring and professional resource for breast forms, bras and accessories such as hats, turbans and bathing suits. Our lingerie department offers a warm comfortable atmosphere with special fitting rooms designed for maximum privacy and comfort, and our certified fitters are available for confidential assistance. The fitters are specially trained to fit women for breast forms, bras, bathing suits and other intimate apparel following a mastectomy, lumpectomy, or other reconstructive surgery.

Thank-you Safeway and Your Customers!

Last October, Safeway donated a financial grant to The Seattle Breast Center through its Charity of Choice program. The Seattle Breast Center is using this generous donation to educate women about early detection of breast cancer and continue to provide state of the art technology and services for the community.

Past Issues

· March, 1998
Volume 13 | Number 1
Tips for Surviving a Brain Attack


Northwest Hospital

Comments and suggestions from readers are encouraged. Write to Med-Info Newsletter, public relations department, Northwest Hospital, 1550 N. 115th Street, Seattle, WA 98133 or call 368-1645 during office hours.

Editor: Valorie Fanger

© Copyright, 1998 Northwest Hospital. All rights reserved.

Some of the text in this newsletter is based upon information from the American Cancer Society and the National Cancer Institute. We appreciate their contribution to this material.
Northwest Hospital and Its Partners Fund Crucial Breast Cancer Awareness Campaign

Thanks to sponsorship from local and national businesses, Northwest Hospital's Seattle Breast Center will launch an important breast cancer awareness campaign this month.

The campaign will focus on explaining the reasons why women should seek early detection of breast cancer and will urge women to undergo screening.

"No one knows what causes breast cancer," said Marita Acheson, MD, Medical Director of Imaging, Seattle Breast Center. "However, we know that a woman has a better chance of fighting breast cancer if she understands the risk factors, how to detect the disease, and the options for treatment."

Each year in America, more than 180,000 women are diagnosed with breast cancer. Approximately 43,900 women die each year and it is the second leading cause of cancer-related death among women ages 35 to 54.

"Early detection and treatment saves lives," said Dr. Acheson. "There are more than 1.6 million breast cancer survivors in America today and the five year survival rate following early diagnosis and treatment is 96%."

Dr. Acheson noted "This breast cancer awareness campaign will reach millions of women in the Seattle area and we believe it will save many lives as a result."

Biopsys, Reed McClure Attorneys at Law, Nordstrom, Seattle's Best Coffee Cafes, KOMO ABC 4 and The Seattle Breast Center at Northwest Hospital are sponsors of the campaign which includes educational vignettes, public service announcements and local programming on the topic of breast cancer.

The campaign concludes with a presentation from Dr. Susan Love, renowned author and women's advocate, on the topic of "Breast Cancer, Myths and Realities" (see box for registration information).

Three Steps to Help You Fight Breast Cancer

The multidisciplinary team of physicians at The Seattle Breast Center recommend the following three step program to fight breast cancer by finding it early:

  1. See your health care provider regularly for a clinical breast exam, starting at age 20.
  2. Get a baseline mammogram by age 40 and have a mammogram every year after age 40.
  3. Learn to do a breast self-examination, and do one every month.

If you have any concerns, do not wait -- see your health care provider now.
For additional information about breast cancer, visit our website at www.seattlebreastcenter.org.

 Frequently Asked Questions (FAQs) about Breast Cancer

What is breast cancer?
Breast cancer is the growth of abnormal cells in the breast, often creating a tumor or lump. The disease kills by spreading, or metastasizing, through the lymphatic system and into the bloodstream. If breast cancer is detected and treated while the tumor is small, there is a 96% chance of survival.

Who is at risk to get breast cancer?
All women are at risk. 85% of newly diagnosed breast cancer patients do not have a family history or other risk factors. Women over the age of 60 are most likely to be diagnosed with the disease. Breast cancer also occurs in men, but it is very rare.

Can anything be done to prevent breast cancer?
The cause of breast cancer is not known, therefore there is no known way to guarantee disease prevention. The recent studies of tamoxifen provide a great deal of promise for breast cancer risk reduction in high risk patients. The best advice to all women is to discover the disease as early as possible through regular breast exams and mammography.

Is breast cancer hereditary?
Only 5 - 10% of women who develop breast cancer have a family history of the disease. Women who have not had children or who were over 35 years old when they had their first child also have been shown to have a slightly higher risk of breast cancer.

Does age have any effect on the risk for breast cancer?
Yes, a woman's risk rises as she grows older. Only 58% of breast cancers are diagnosed when confined to the breast. Regular mammography combined with regular clinical breast exams offer the best opportunity to increase this percentage.

What should I do if I find a lump?
About 80% of all breast lumps are benign, meaning that they are not cancer. Any new lump or change must be evaluated by your physician. Tests such as mammography and ultrasound may be needed to determine if cancer is present. Never assume any new lump is benign until it is proven to be.

Who should have a mammogram?
Mammograms, or breast x-rays, are important tools in detecting breast cancer early, when it is most curable. The American Cancer Society and the Seattle Breast Center recommend that women have a baseline screening mammogram by age 40, and a mammogram every year after that age. If you have a family history of breast cancer, discuss it with your physician. You may need to have a screening mammogram sooner. These screening guidelines are for women do not have any breast changes. If you have symptoms, see your physician for an examination right away.

Where can I go to talk with other breast cancer patients?
Northwest Hospital hosts classes and support groups. The breast cancer patient support group has ongoing meetings on campus. For more information, call 368-1606.

What are the treatment options for breast cancer patients?
Tremendous strides have been made in the treatment of breast cancer. Talk to your physician about the possible options --; surgery, radiation therapy, chemotherapy or hormone therapy --; to decide which option is best for you.

Multidisciplinary Team of Physicians Collaborate to Provide Better Care

The Seattle Breast Center's multi-disciplinary approach is designed to address a woman's need to make confident decisions about her care, based on balanced opinions from a collaborative group of physicians and breast health specialists. The team of Seattle-area physicians and nurses is composed of specialists in mammography, surgery, radiation oncology, medical oncology, pathology, reconstructive surgery, research/development and psychological support. The team meets weekly to discuss patient treatment plans and current issues in breast cancer treatment.

Mapping a Better Future for Breast Cancer Patients

Only about one-third of women with breast cancer actually need to have the lymph nodes under the arm removed because of breast cancer. But the procedure is done in virtually every case.

That's because the lymph system is the primary carrier of cancer cells to other parts of the body: if the breast cancer has spread to the axilla, as these nodes are called, it may well have spread elsewhere.

Most of the time, this doesn't happen. "The problem," said Northwest Hospital surgeon Alan Morgan, MD, "is that we don't know which 'third' a woman is in until we take the nodes out and examine them. So, we do it all the time to be safe and for future planning purposes."

Given the risks of the procedure - swollen arms, stiffness of the shoulder, and possible permanent nerve damage and loss of movement - physicians are continually searching for another way to find out if breast cancer has spread.

They may have found it.

The procedure, called "sentinel lymph node mapping," has already proven itself for melanoma, the virulent malignant skin cancer. It was adapted by Armando Giuliano, MD, of The John Wayne Cancer Center in Santa Monica, who quickly saw its implications for breast cancer and began clinical trials. Northwest Hospital is one of only two hospitals studying the technique here in Seattle.

The Sentinel Node: The First to See Cancer Cells
According to the dictionary, a sentinel is someone or something that keeps watch - a sentry. Physicians borrowed the word to describe the first lymph node to receive lymph from the site of the tumor. The theory is that if this node is cancer-free, so is the rest of the axilla. There's a 95 percent or more probability that cancer will not be found in the rest of the axilla.

However, as Dr. Morgan explained, "each area of the breast drains to a different node, so the first challenge is to find the sentinel node."

Seeking a Clearer Vision
Physicians at Northwest are using a combination of techniques to improve the odds of finding that node. First, they inject the breast with a blue dye just before surgery. The sentinel node takes up the dye and becomes visible - it "visualizes," the doctors say.

Robert Howisey, MD, Northwest Hospital surgeon, said that the dye works well most of the time, but placement of the injection is critical, creating a significant learning curve for physicians. Patients assimilate the dye at different rates, so it doesn't always illuminate the lymph node when surgeons need to see it. Because of these limitations, Northwest's physicians decided to use the dye in combination with a radioactive isotope, which lasts longer in the body and is commonplace in other procedures. The nodes visualize on x-ray scans and can then be removed and examined separately from other nodes.

The procedure visualizes sentinel nodes about 80 percent of the time, Dr. Morgan said. "Our preliminary results show that the location of the tumor affects visualization - in the 50 women who've taken part in our study so far, sentinel lymph nodes were more likely to be visible when tumors were located in the outer half of the breast or toward the outside, nearest the arms. Of course, there are other factors affecting visualization. An aggressive tumor may have already blocked the lymphatics, for example, and we won't be able to see them."

A Promise and a Caution The time spent refining visualization techniques is well worth it, Dr. Morgan thinks: of the sentinel nodes found in 50 women at Northwest, only two tested negative for cancer when the disease had, in fact, spread.

These few women are reason enough for the physicians to emphasize caution. "Sentinel lymph node mapping is a very promising technique with enormous implications for breast cancer, and for other cancers," Dr. Morgan said. "Virtually millions of women may be spared the pain, the risk, and the expense of axillary excision.

"At Northwest, we still recommend the full excision procedure, but we're very optimistic that this will soon change. With this team of physicians treating breast cancer patients at Northwest, there is great hope for the future."
Two community services of Northwest Hospital
www.seattlebreastcenter.org
A great source for breast cancer information
&
800-633-4636
For physician referral or to speak to a nurse


Thanks to the generous support of these companies, Northwest Hospital's Seattle Breast Center and KOMO ABC 4 are able to inform women about breast cancer to help save lives.



Seattle's Best Coffee Cafes

Seattle's Best Coffee Cafes are proud to support Northwest Hospital and its fight against breast cancer. During the month of May, Seattle's Best Coffee Cafes will donate a portion of proceeds from purchases of Bistro Blend, our newest Coffee House Blend to the center.


Barnes and Noble at the University Village
Helps Raise Money for Breast Cancer Awareness Campaign

Thanks to the University Village Barnes and Noble, Dr. Susan Love's two books "Dr. Susan Love Breast Book" and "Dr. Susan Love's Hormone Book" will be available for purchase at the Dr. Susan Love event on May 13, 1998. A percent of sales will be donated to the breast cancer awareness campaign.



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